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    Improve your claim denial management

    1st: Heal thyself

    The first step is to remove the physician from the day-to-day denials-management process. Physicians around the world are already spending too much time behind a computer screen. A study published in the Annals of Internal Medicine found physicians spend a significant part of their day not treating patients, but instead completing other tasks. These physicians spent approximately 27 percent of their time in face-to-face clinical contact with patients, while spending up to four hours on “desk work” for every one hour treating patients. This study had a somewhat small sample size, but it’s easy to see that as contracting and billing grows more complex, physicians may spend more time with a computer and less with patients.From the 4/10/18 issue of Medical Economics.


    More: Top 8 worst administrative hassles according to physicians


    Whether the billing experts are members of the practice or external experts, physicians who hand off the denials management process increase the time they can spend with patients, and can improve productivity and boost revenue by allowing experts to take control of the process.


    2nd: Automate

    Artificial intelligence (AI) is all over the news today, often classified as a savior to business or the end of the workplace as we know it. The truth, like anything, is somewhere in between. AI, like other technologies, is a tool that can be used to increase productivity and efficiency. For providers, AI’s older sibling, automation, can be used to decrease, or even eliminate, denials.

    As a business practice, automation can be used to enhance the provider’s office staff. An automated denials management solution can increase efficiency by allowing staff to focus on other issues that require resolution. 

    A well-thought-out automated denials management solution actually starts long before any claim is denied. To whittle away at the 90 percent of denials that are avoidable, the process should begin early. 

    Next: Bringing it all together

    Kevin Lathrop
    Kevin Lathrop is president of TriZetto Providers Solutions, which provides revenue cycle management systems to providers.

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    • [email protected]
      Great article , completely agree Physicians need to focus on what they trained for and outsource the rest to people who are experts in that field #prime healthtek

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